Contraindications to Plasma Donation
Plasma donation is contraindicated in individuals with HIV, hepatitis C, and other infectious diseases that could be transmitted through blood products. 1
Infectious Disease Contraindications
- HIV infection is an absolute contraindication to plasma donation 1
- Active hepatitis C infection is an absolute contraindication 1
- Positive rapid plasma reagin (RPR) test requires evaluation and treatment for syphilis before donation consideration 1
- Presence of hepatitis B surface antibody alone (without active infection) is not a contraindication 1
- Tuberculosis screening with PPD skin test is recommended for donors from endemic areas 1
Cardiovascular and Pulmonary Contraindications
- Hypertension with blood pressure ≥140/90 mmHg on at least two office measurements 1
- Significant atherosclerotic disease 1
- Fibromuscular dysplasia 1
- Moderate to severe pulmonary disease (FEV1 or FVC <70% of predicted or FEV1:FVC ratio <65%) 1
Renal and Urinary Tract Contraindications
- Proteinuria confirmed by 24-hour urine collection 1
- Evidence of renal tuberculosis 1
- Interstitial nephritis or pyelonephritis 1
- Significant unilateral renal atrophy or horseshoe kidney 1
- Significant cortical scarring 1
- Multiple kidney cysts (2 or 3 cysts in each kidney) or complex/septated cysts 1
- Angiomyolipoma 1
- Current kidney stones or recurrent history of stones 1
Metabolic and Endocrine Contraindications
- Diabetes mellitus or impaired glucose tolerance with additional risk factors (first-degree relatives with type 2 diabetes, obesity, history of gestational diabetes, dyslipidemia) 1
- High-range impaired fasting glucose (110-125 mg/dL) 1
Autoimmune and Rheumatologic Contraindications
- Systemic lupus erythematosus (SLE) 1
- Family member of a patient with SLE who has a positive ANA result 1
- Familial primary glomerulonephritis conditions including IgA nephropathy, focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis, and membranous nephropathy 1
Malignancy-Related Contraindications
- Active malignancy 1
- History of malignancy unless deemed cured and potential for transmission excluded (requires oncology clearance) 1
Other Medical Contraindications
- Severe obesity (BMI >35 kg/m²) with other comorbid conditions 1
- Jehovah's Witness adherents or individuals who refuse transfusion of blood products 1
- Current use of genotoxic drugs (requires waiting period of tmax + 24 t1/2) 2
- Current use of retinoids, thalidomide, lenalidomide, dutasteride, or finasteride (requires specific waiting periods) 2
- History of anaphylactic reactions to plasma products 3
Practical Considerations
- Donors taking medications may be deferred depending on the medication type and plasma product intended 2
- Irreversible inhibitors of platelet function cause a 10-day waiting period if production of platelet concentrates is intended 2
- Convenience issues (schedule conflicts, time constraints) are common reasons donors stop donating, though not formal contraindications 4
Screening Requirements
- All potential donors must undergo screening for HIV, hepatitis B and C 1
- Age-appropriate malignancy screening is recommended (colorectal cancer screening starting at age 50, breast cancer screening starting at age 40, cervical cancer screening starting at age 18, prostate cancer screening starting at age 50) 1
- Blood pressure measurements should document systolic blood pressure <140 mmHg and diastolic pressure <90 mmHg 1
Special Considerations
- Donors with a history of anaphylactic reactions to plasma products may require alternative approaches if therapeutic plasma exchange is needed 3
- The safety profile of plasma products has improved significantly over time with advanced screening and viral attenuation techniques 5
- Potential donors should be aware that donation frequency limitations exist to maintain donor health 4